Chapter 31 Workbook Flashcards by Tom Bowl

Soft tissue damage inside the body, but the skin remains intact

Closed abdominal injury

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Displacement of organs outside the body

Evisceration

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The posterior region below the margin of the lower rib cage

Flank

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Contracting stomach muscles to minimize pain

Guarding

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Examples include the stomach, small intestine, and ureters

Hollow organs

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Blood in the urine

Hematuria

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An injury in which a foreign object enters the abdomen and opens the peritoneal cavity to the outside

Open abdominal injury

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An abdominal cavity

Peritoneal cavity

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Examples include the liver, pancreas, and spleen

Solid organs

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All of the following systems contain organs that make up the contents of the abdominal cavity except:
A. the digestive system
B. the urinary system
C. the genitourinary system
D. the limbic system

D. the limbic system

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Which of the following is not a hollow organ of the abdomen?
A. Stomach
B. Liver
C. Bladder
D. Ureters

B. Liver

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Which of the following is not a solid organ of the abdomen?
A. Liver
B. Spleen
C. Gallbladder
D. Pancreas

C. Gallbladder

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The first signs of peritonitis include all of the following except:
A. severe abdominal pain
B. tenderness
C. muscular spasm
D. nausea

D. nausea

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Late signs of peritonitis may include:
A. a soft abdomen
B. abdominal distention
C. normal bowel sounds
D. diarrhea

B. abdominal distention

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______ take(s) place in the solid organs.
A. Digestion
B. Excretion
C. Endocrine functions
D. Absorption

C. Endocrine functions

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Because solid organs have a rich supply of blood, any injury can result in major:
A. hemorrhaging
B. damage
C. pain
D. guarding

A. hemorrhaging

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The ______ is often injured during motor vehicle collisions, especially in the cases of improperly placed seat belts or impact from the steering wheel, falls from heights or onto sharp objects, and bicycle and motorcycle crashes where the patient hits the handlebars on impact.
A. pancreas
B. heart
C. spleen
D. colon

C. spleen

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Any air in the peritoneal cavity seeks the most ______ space or void; thus, the location of the air can change with the positioning of the patient.
A. inferior
B. superior
C. distal
D. proximal

B. superior

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The abdomen is divided into four:
A. quadrants
B. planes
C. sections
D. angles

A. quadrants

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The largest organ in the abdomen is the:
A. liver
B. spleen
C. pancreas
D. kidneys

A. liver

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Open abdominal injuries are also known as:
A. blunt injuries
B. collapse injuries
C. penetrating injuries
D. peritoneal injuries

C. penetrating injuries

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Blunt abdominal injuries may result from:
A. a stab wound
B. seat belts
C. a gunshot wound
D. an impaled object

B. seat belts

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The major complaint of patients with abdominal injury is:
A. pain
B. tachycardia
C. rigidity
D. swelling

A. pain

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A very common early sign of a significant abdominal injury and shock is:
A. pain
B. tachycardia
C. rigidity
D. distention

B. tachycardia

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Late signs of abdominal injury include all of the following except: A. distention B. increased blood pressure C. change in mental status D. pale, cool, moist skin

B. increased blood pressure

Your primary concern when dealing with an unresponsive patient with an open abdominal injury is: A. covering the wound with a moist dressing B. maintaining the airway C. controlling the bleeding D. monitoring vital signs

C. controlling the bleeding

You respond to an 18-year-old high school football player who was hit in the right flank with a helmet several hours ago. He is complaining of pain in the area. He is alert and oriented. His airway is open, and his respirations are within normal limits. His pulse is rapid and regular. He has a radial pulse. He tells you that he is noticing blood in his urine. Based on this information, the patient is likely to have an injury to the: A. liver B. kidney C. gallbladder D. appendix

B. kidney

When performing a history on a patient with abdominal trauma, all of the following questions would be appropriate regarding trauma except: A. Is there any blood in your stool? B. Does your pain go anywhere? C. Do you have any nausea, vomiting, or diarrhea? D. Are you having trouble with your hearing?

D. Are you having trouble with your hearing?

If the seat belt lies too high, it can do all of the following except: A. squeeze abdominal organs B. compress the great vessels C. fracture the lumbar spine D. rupture the appendix

D. rupture the appendix

You are dispatched to a motor vehicle collision. Your patient is a 42-year-old restrained woman. The airbag deployed, and the woman has abrasions on her face. She is complaining of pain to both her chest and abdomen. Her airway is open, and respirations are within normal limits. Her pulse is a little rapid but strong and regular. She has distal pulses. In assessing this patient, which of the following statements is not true? A. Bowel sounds may help confirm findings. B. Palpation is typically performed first with light touch. C. If light touch elicits pain, perform deep palpation to assess further injury. D. If you find an entry wound, you should always assess for an exit wound.

C. If light touch elicits pain, perform deep palpation to assess further injury.

Patients with open abdominal injuries often complain of: A. pain B. nausea C. vomiting D. dyspnea

A. pain

You are called to the local bar where a fight has taken place. The police department tells you that you have a 36 year old man who has been stabbed twice in the abdomen. On arrival, the patient is alert and oriented. His airway is open. His respirations are at 24 breaths/min; pulse is rapid, regular, and weak. He has distal pulses. With the penetrating trauma, you should assume that the object has done all of the following except: A. has penetrated the peritoneum B. has entered the abdominal cavity C. has possibly injured one or more organs D. has damaged only the skin

D. has damaged only the skin

When treating a patient with an evisceration, you should: A. attempt to replace the abdominal contents B. cover the protruding organs with a dry, sterile dressing C. cover the protruding organs with adherent dressings D. cover the protruding contents with moist, sterile gauze compresses

D. cover the protruding contents with moist, sterile gauze compresses

The solid organs of the urinary system include the: A. kidneys B. ureters C. bladder D. urethra

A. kidneys

All of the following male genitalia lie outside the pelvic cavity except: A. the urethra B. the penis C. the seminal vesicles D. the testes

C. the seminal vesicles

Suspect kidney damage if the patient has a history or physical evidence of all of the following except: A. an abrasion, laceration, or contusion in the flank B. a penetrating wound in the region of the lower rib cage or the upper abdomen C. fractures on either side of the lower rib cage D. a hematoma in the umbilical region

D. a hematoma in the umbilical region

Signs of injury to the kidney may include any of the following except: A. bruises or lacerations on the overlying skin B. shock C. vomiting D. hematuria

C. vomiting

Suspect a possible injury of the urinary bladder in all of the following findings except: A. bruising to the left upper quadrant B. blood at the urethral opening C. blood at the tip of the penis or a stain on the patient’s underwear D. physical signs of trauma on the lower abdomen, pelvis, or perineum

A. bruising to the left upper quadrant

When treating a patient with an amputation of the penile shaft, your top priority is: A. locating the amputated part B. controlling bleeding C. keeping the remaining tissue dry D. delaying transport until bleeding is controlled

B. controlling bleeding

In any case of trauma to a female patient, you should always determine if the patient: A. is on birth control B. is pregnant C. is currently menstruating D. has a history of ovarian cysts

B. is pregnant

In cases of sexual assault, which of the following is true? A. You should always examine the genitalia for any sign of injury. B. Advise the patient not to wash, urinate, or defecate. C. In addition to recording the facts, it is important to include your personal thoughts. D. You should use plastic bags when collecting items such as clothes.

B. Advise the patient not to wash, urinate, or defecate.

True/False Hollow organs may release free air into the abdomen if injured.

True

True/False One of the most common signs of a significant abdominal injury is an elevated pulse rate.

True

True/False Patients with abdominal injuries should be kept supine with the head elevated.

False

True/False Peritoneal irritation is in response to hollow organ injury.

True

True/False Eviscerated organs should be covered with a dry dressing.

False

True/False Injuries to the kidneys usually occur in isolation.

False

True/False Peritonitis is an inflammation of the peritoneum.

True

True/False The abdomen is divided into two quadrants.

False

True/False Patients with abdominal pain may want to lie still with their legs drawn up.

True

Severe bleeding may occur with injury to __________ organs.

solid

The __________ are filtration organs and are therefore supplied with large quantities of __________ and prone to bleed heavily when injured.

kidneys, blood

Kidneys are located in the __________ space.

retroperitoneal

A penetrating wound that reaches the kidneys almost always involves __________ __________.

other organs

When ruptured, the organs of the abdominal cavity can spill their contents into the peritoneal cavity, causing an intense inflammatory reaction called __________.

peritonitis

Spilled contents from ruptured hollow organs may irritate the __________ __________ and cause the patient to report abdominal pain.

peritoneal cavity

Closed abdominal injuries are also known as __________ __________.

blunt injuries

Open abdominal injuries are also known as __________ __________.

penetrating injuries

The region below the rib cage and above the hip is called the __________.

flank

An open wound that allows internal organs or fat to protrude through the wound is called __________.

evisceration

Hollow Organs A. Stomach B. Gallbladder C. Bile duct D. Large intestine E. Ureter F. Small intestine G. Fallopian tubes H. Rectum I. Appendix J. Uterus K. Urinary bladder

Solid Organs A. Liver B. Spleen C. Adrenal gland D. Adrenal gland E. Pancreas F. Kidney G. Kidney H. Ovaries

Short Answers List the hollow organs of the abdomen and urinary system.

Stomach, intestines, ureters, bladder, gallbladder, bile duct, appendix, uterus, fallopian tubes, and rectum

Short Answers List the solid organs of the abdomen and urinary system.

Liver, spleen, pancreas, adrenal glands, ovaries, and kidneys

Short Answers List the signs and symptoms of an abdominal injury.

* Pain * Guarding * Distention * Tenderness * Bruising and discoloration * Abrasions * Tachycardia * Shock signs * Lacerations * Bleeding * Difficulty with movement because of pain

Short Answers List the major history or physical findings associated with possible kidney damage.

* An abrasion, laceration, or contusion in the flank * A penetrating wound in the flank (the region below the rib cage and above the hip) or the upper abdomen * Fractures on either side of the lower rib cage or of the lower thoracic or upper lumbar vertebrae * A hematoma in the flank region

Ambulance Calls You are dispatched to a local bar where your patient, a 26‑year‑old man, was involved in an altercation. He has several superficial lacerations to his arms, and a knife is impaled in his right upper quadrant. He is lying supine on the floor. He is alert. The bar patrons tell you that he did not fall but that they helped him to the floor. How would you best manage this patient?

Assess the patient’s ABCs and apply high flow oxygen or a bag mask device if needed. Control any bleeding. Stabilize the knife in place with bulky dressings—do not remove it. Keep movement of the patient to the bare minimum so as not to create further injury. (Sliding the patient very carefully onto a backboard may help to minimize movement.) Monitor vital signs, and provide rapid transport. Keep patient warm and treat for shock if signs and symptoms present. Bandage minor lacerations en route.

Ambulance Calls You are dispatched to assist police with a mentally ill patient who has threatened harm to himself and others. Police officers found the man running around his home with a knife and blood all over his lower body. The man tells you that “the voices” told him to cut off his penis. How would you best manage this patient?

Ensure that the scene is safe. Quickly visualize the area to determine how badly he has cut himself and whether he has in fact amputated any portion of his penis. You will need to control bleeding because blood loss in this area can be significant. Use direct pressure and/or pressure dressings to control bleeding. If a portion of the penis is amputated, wrap it in a moist, sterile dressing, place it in a plastic bag, and transport it in a cooled container. Do not allow it to come in direct contact with ice. Provide high flow oxygen and prompt transport. Also, request the presence of a police officer during transport because this patient will likely need to be restrained and could be unpredictable during transport.

Ambulance Calls You are dispatched to a construction site where a man has fallen onto a piece of rebar. You arrive to find a man sitting on the ground with his legs drawn toward his chest. He tells you that he fell from a ladder onto a piece of rebar. He says, “Something’s sticking out of me.” As you visualize his abdomen, you can clearly see a portion of his bowel on the outside of his body. How would you best manage this patient?

Cover the abdomen and the portion of the protruding bowel with a moistened, sterile dressing and/or an occlusive dressing. Secure these dressings with tape. Allow the patient to draw up his knees as needed for comfort. Apply high flow oxygen, cover the patient to preserve warmth, treat for shock as needed, and promptly transport to the hospital.

If you are treating a patient with an abdominal evisceration, you should use a(n): A. moist, sterile dressing B. dry, sterile dressing C. adhesive dressing D. triangular bandage

A. moist, sterile dressing

You have a male patient who has no immediate life threat but does have bleeding genitalia. You should bandage with a(n): A. dry dressing B. moist dressing C. occlusive dressing D. adhesive dressing

A. dry dressing

You have a patient with suspected kidney injury but no spinal injury. How should he be positioned? A. Supine B. Prone C. Lateral recumbent D. Position of comfort

D. Position of comfort

Your patient has his penis caught in his zipper. What do you need to do to relieve the pressure? A. Pull the pants off the patient. B. Force the zipper open. C. Remove the foreskin. D. Cut the zipper out of the pants.

D. Cut the zipper out of the pants.

Whenever possible, you should always provide the sexual assault patient with: A. a police escort B. privacy to use the restroom C. an attendant of the same gender D. the name of the assailant

C. an attendant of the same gender

Chapter 31 Workbook Flashcards

(74 cards)